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PARAMEDIC-2

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https://www.readbyqxmd.com/read/27833674/alternative-destination-transport-the-role-of-paramedics-in-optimal-use-of-the-emergency-department
#1
Michael M Neeki, Fanglong Dong, Leigh Avera, Tan Than, Rodney Borger, Joe Powell, Reza Vaezazizi, Richard Pitts
INTRODUCTION: Alternative destination transportation by emergency medical services (EMS) is a subject of hot debate between those favoring all patients being evaluated by an emergency physician (EP) and those recognizing the need to reduce emergency department (ED) crowding. This study aimed to determine whether paramedics could accurately assess a patient's acuity level to determine the need to transport to an ED. METHODS: We performed a prospective double-blinded analysis of responses recorded by paramedics and EPs of arriving patients' acuity level in a large Level II trauma center between April 2015 and November 2015...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27650864/pre-hospital-assessment-of-the-role-of-adrenaline-measuring-the-effectiveness-of-drug-administration-in-cardiac-arrest-paramedic-2-trial-protocol
#2
Gavin D Perkins, Tom Quinn, Charles D Deakin, Jerry P Nolan, Ranjit Lall, Anne-Marie Slowther, Matthew Cooke, Sarah E Lamb, Stavros Petrou, Felix Achana, Judith Finn, Ian G Jacobs, Andrew Carson, Mike Smyth, Kyee Han, Sonia Byers, Nigel Rees, Richard Whitfield, Fionna Moore, Rachael Fothergill, Nigel Stallard, John Long, Susie Hennings, Jessica Horton, Charlotte Kaye, Simon Gates
Despite its use since the 1960s, the safety or effectiveness of adrenaline as a treatment for cardiac arrest has never been comprehensively evaluated in a clinical trial. Although most studies have found that adrenaline increases the chance of return of spontaneous circulation for short periods, many studies found harmful effects on the brain and raise concern that adrenaline may reduce overall survival and/or good neurological outcome. The PARAMEDIC-2 trial seeks to determine if adrenaline is safe and effective in out-of-hospital cardiac arrest...
November 2016: Resuscitation
https://www.readbyqxmd.com/read/26387211/comparison-of-the-release-behaviors-of-di-2-ethylhexyl-phthalate-and-tri-2-ethylhexyl-trimellitate-from-the-polyvinyl-chloride-infusion-set-into-pharmaceutical-solutions
#3
COMPARATIVE STUDY
Hong Zhang, Fengmin Yang, Gang Shen, Yueyang Yang, Yalin Tang
Polyvinyl-chloride (PVC) with plasticizers of di(2-ethylhexyl) phthalate (DEHP) and tris(2-ethyl- hexyl) trimellitate (TOTM) is widely used in medical and paramedical appliances. However, such plasticizers can leach from PVC products into contact solutions. The aim of this study is to investigate the release behaviors of DEHP and TOTM from the PVC intravenous infusion set into various pharmaceutical solutions under the simulated clinical conditions, such as the lipophilic substances (paclitaxel) , parenteral nutrition (fat emulsion injection) , acid and alkali pharmaceutical solution (levofloxacin hydrochloride injection, pH 3...
May 2015: Se Pu, Chinese Journal of Chromatography
https://www.readbyqxmd.com/read/26375661/the-impact-of-a-pre-hospital-critical-care-team-on-survival-from-out-of-hospital-cardiac-arrest
#4
Johannes von Vopelius-Feldt, Archibald Coulter, Jonathan Benger
AIM: To assess the impact of a pre-hospital critical care team (CCT) on survival from out-of-hospital cardiac arrest (OHCA). METHODS: We undertook a retrospective observational study, comparing OHCA patients attended by advanced life support (ALS) paramedics with OHCA patients attended by ALS paramedics and a CCT between April 2011 and April 2013 in a single ambulance service in Southwest England. We used multiple logistic regression to control for an anticipated imbalance of prognostic factors between the groups...
November 2015: Resuscitation
https://www.readbyqxmd.com/read/26359283/use-and-abuse-of-medication-during-2014-fifa-world-cup-brazil-a-retrospective-survey
#5
Martin Vaso, Alexis Weber, Philippe M Tscholl, Astrid Junge, Jiri Dvorak
OBJECTIVE: To examine the use of medication of top-level male players during the 2014 FIFA World Cup Brazil. DESIGN: Retrospective survey. PARTICIPANTS/INFORMATION: 736 top level players. SETTING: The teams' physicians disclosed a list of the medications used by each player within 72 h before each match of the 2014 FIFA World Cup Brazil. OUTCOME MEASURES: Average number of medications used per player per match or during the tournament; average number and percentage of players using at least one medication per match or during the tournament...
2015: BMJ Open
https://www.readbyqxmd.com/read/26358516/establishing-a-definitive-airway-in-the-trauma-patient-by-novice-intubators-a-randomised-crossover-simulation-study
#6
RANDOMIZED CONTROLLED TRIAL
Itai Shavit, Barak Levit, Nofar Ben Basat, Dekel Lait, Mostafa Somri, Luis Gaitini
BACKGROUND: Establishing a definitive airway, defined as a tube placed in the trachea with cuff inflated below the vocal cords, is standard of care in pre-hospital airway management of the trauma patient. However, in this setting, and using manual in-line stabilisation of the neck, success rate of intubation by inexperience providers is suboptimal. The use of supraglottic airway devices that allow blind tracheal intubation has been suggested as an alternative method by the Advanced Trauma Life Support (ATLS) programme of the American College of Surgeons...
November 2015: Injury
https://www.readbyqxmd.com/read/26320522/pediatric-intubation-by-paramedics-in-a-large-emergency-medical-services-system-process-challenges-and-outcomes
#7
Matthew E Prekker, Fernanda Delgado, Jenny Shin, Heemun Kwok, Nicholas J Johnson, David Carlbom, Andreas Grabinsky, Thomas V Brogan, Mary A King, Thomas D Rea
STUDY OBJECTIVE: Pediatric intubation is a core paramedic skill in some emergency medical services (EMS) systems. The literature lacks a detailed examination of the challenges and subsequent adjustments made by paramedics when intubating children in the out-of-hospital setting. We undertake a descriptive evaluation of the process of out-of-hospital pediatric intubation, focusing on challenges, adjustments, and outcomes. METHODS: We performed a retrospective analysis of EMS responses between 2006 and 2012 that involved attempted intubation of children younger than 13 years by paramedics in a large, metropolitan EMS system...
January 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26281820/risk-factors-for-posttraumatic-stress-disorder-in-polish-paramedics-a-pilot-study
#8
Beata Rybojad, Anna Aftyka, Michalina Baran, Patryk Rzońca
BACKGROUND: Working as a paramedic carries the risk of witnessing events and personal experiences associated with emergency life-threatening circumstances that may result in symptoms associated with posttraumatic stress. This problem is well known but still underestimated. OBJECTIVES: The specific study objectives were to 1) assess the influence of sociodemographic and occupational factors on posttraumatic stress disorder (PTSD) among paramedics, and 2) suggest preventive strategies in this population...
February 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26270935/prehospital-care-of-burn-patients-and-trajectories-on-survival
#9
Outi Kallinen, Virve Koljonen, Erkki Tukiainen, Tarja Randell, Hetti Kirves
We sought to identify factors associated with the prognosis and survival of burn patients by analyzing data related to the prehospital treatment of burn patients transferred directly to the burn unit from the accident site. We also aimed to assess the role of prehospital physicians and paramedics providing care to major burn patients. This study included adult burn patients with severe burns treated between 2006 and 2010. Prehospital patient records and clinical data collected during treatment were analyzed, and the Injury Severity Scale (ISS) was calculated...
2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26265130/routing-ambulances-to-designated-centers-increases-access-to-stroke-center-care-and-enrollment-in-prehospital-research
#10
Nerses Sanossian, David S Liebeskind, Marc Eckstein, Sidney Starkman, Samuel Stratton, Franklin D Pratt, William Koenig, Scott Hamilton, May Kim-Tenser, Robin Conwit, Jeffrey L Saver
BACKGROUND AND PURPOSE: Emergency medical services routing of patients with acute stroke to designated centers may increase the proportion of patients receiving care at facilities meeting national standards and augment recruitment for prehospital stroke research. METHODS: We analyzed consecutive patients enrolled within 2 hours of symptom onset in a prehospital stroke trial, before and after regional Los Angeles County Emergency Medical Services implementation of preferentially routing patients with acute stroke to approved stroke centers (ASCs)...
October 2015: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/26206544/the-need-for-a-uk-helicopter-emergency-medical-service-by-night-a-prospective-simulation-study
#11
Richard M Lyon, Joe Vernon, Magnus Nelson, Neal Durge, Malcolm Tunnicliff, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Major trauma commonly occurs at night. Helicopter emergency medical services (HEMS) can provide advanced prehospital care to victims of major trauma but do not routinely operate at night in the United Kingdom. We sought to prospectively examine the need for a night HEMS service in Kent, Surrey, and Sussex in the United Kingdom. METHODS: A 4-month, prospective study was conducted (July 1, 2012-October 31, 2012). HEMS dispatch paramedics were present in the ambulance dispatch center and undertook simulated HEMS activations when a suitable case was identified...
July 2015: Air Medical Journal
https://www.readbyqxmd.com/read/26192931/two-types-of-prehospital-systems-interventions-that-triage-low-acuity-patients-to-alternative-sites-of-care
#12
COMPARATIVE STUDY
Kurt Krumperman, Steven Weiss, Lynne Fullerton
OBJECTIVES: This study retrospectively compared alternatives for navigating low-acuity patients in two emergency medical services systems. System A involved a response to every 9-1-1 request with an "evaluate, treat, and refer" process, in which paramedics decided whether patients could be treated on-scene and referred to a primary care provider or urgent care center. System B used a "telephone triage and referral" process, in which callers of low severity were diverted from 9-1-1 to call centers where nurses provided advice and/or a referral to a primary care provider/urgent care center...
July 2015: Southern Medical Journal
https://www.readbyqxmd.com/read/26186993/clinically-meaningful-reduction-in-pain-severity-in-children-treated-by-paramedics-a-retrospective-cohort-study
#13
Paul A Jennings, Bill Lord, Karen Smith
INTRODUCTION: Pediatric pain is a common presenting symptom in the prehospital setting; however, there is a lack of data identifying factors associated with effective pain management in this population. We sought to identify the factors associated with clinically meaningful pain reduction in children. METHODS: An analysis of electronic patient care records of all patients younger than 15 years presenting with pain to the emergency medical service of Victoria, Australia, over a 4-year period (2008-2011)...
November 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26168871/survival-to-discharge-after-cardiac-arrest-attended-by-a-doctor-paramedic-helicopter-emergency-medical-service-an-utstein-style-multiservice-review-of-1085-activations
#14
Adam Chesters, Tim Harris, Timothy J Hodgetts, Nadine Keefe
BACKGROUND: The presentation of outcomes after cardiac arrest presented by emergency medical service and in-hospital teams in the Utstein style allows for comparative analysis of populations and systems. Essex and Herts Air Ambulance Trust (EHAAT) and the East Anglian Air Ambulance (EAAA) are doctor-plus-paramedic prehospital care teams that respond to a large number of medical cardiac arrests. OBJECTIVE: To report the outcomes of medical cardiac arrests according to the Utstein style...
October 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26134056/a-prehospital-treat-and-release-protocol-for-supraventricular-tachycardia
#15
Rajan Minhas, Gregory Vogelaar, Dongmei Wang, Wadhah Almansoori, Eddy Lang, Ian E Blanchard, Gerald Lazarenko, Andrew McRae
OBJECTIVE: Paroxysmal supraventricular tachycardia (SVT) is a common dysrhythmia treated in the prehospital setting. Emergency medical service (EMS) agencies typically require patients treated for SVT to be transported to the hospital. This retrospective cohort study evaluated the impact, paramedic adherence, and patient re-presentation rates of a treat-and-release (T+R) protocol for uncomplicated SVT. METHODS: Data were linked from the Alberta Health Services EMS electronic patient care record (EPCR) database for the City of Calgary to the Regional Emergency Department Information System (REDIS)...
July 2015: CJEM
https://www.readbyqxmd.com/read/26112769/mathematical-ability-of-first-year-undergraduate-paramedic-students-a-before-and-after-study
#16
Kathryn Eastwood, Malcolm Boyle, Visal Kim, Nathan Stam, Brett Williams
BACKGROUND: An ability to accurately perform drug calculations unassisted is an essential skill for all health professionals, with various occupational-specific stressors exacerbating mathematical deficiencies. OBJECTIVES: The objective of this study was to determine the unaided mathematic ability of first year undergraduate paramedic students before and after mathematical and drug calculation tutorials. METHODS: Students were administered a questionnaire containing demographic, drug calculation and arithmetic questions during week one of the semester before the tutorials...
November 2015: Nurse Education Today
https://www.readbyqxmd.com/read/26102809/3c-07-are-the-physicians-reluctant-to-practice-telemedicine-in-hypertension
#17
M Lopez Sublet, P Y Courand, S Bally, T Krummel, Y Dimitrov, M Brucker, S Regnier-Le Coz, C Dourmap-Collas, J J Mourad, O Steichen, J Ott, G Barone-Rochette, L Bogetto-Graham, P Rossignol, N Barber-Chamoux, S Le Jeune, E Vautrin, D Agnoletti, S Baguet, P Sosner
OBJECTIVE: The high number of patients with uncontrolled hypertension is still a public health pattern. The e-health contains all electronic health services used in order to improve communication between all the different actors. In arterial hypertension, few data exists on the possibilities: 1/ for patients to easily e-transfer their results of home blood pressure measurement (HBPM); 2/ for practitioners to receive and assess these HBPM results. Furthermore, physician's reluctance is often reported as a constraint for telemedicine development...
June 2015: Journal of Hypertension
https://www.readbyqxmd.com/read/26086869/summer-indoor-heat-exposure-and-respiratory-and-cardiovascular-distress-calls-in-new-york-city-ny-u-s
#18
C K Uejio, J D Tamerius, J Vredenburg, G Asaeda, D A Isaacs, J Braun, A Quinn, J P Freese
Most extreme heat studies relate outdoor weather conditions to human morbidity and mortality. In developed nations, individuals spend ~90% of their time indoors. This pilot study investigated the indoor environments of people receiving emergency medical care in New York City, NY, U.S., from July to August 2013. The first objective was to determine the relative influence of outdoor conditions as well as patient characteristics and neighborhood sociodemographics on indoor temperature and specific humidity (N = 764)...
August 2016: Indoor Air
https://www.readbyqxmd.com/read/26069160/drugs-for-the-doctor-s-bag-2-children
#19
(no author information available yet)
In May 2015, DTB published Drugs for the doctor's bag: 1-adults,(1) recognising the fact that there is still a need for some GPs to carry a range of medicines for use in acute situations when on home visits. What to include in the GP's bag is determined by the medical conditions likely to be met; medicines the GP is confident and competent to use; storage requirements and shelf-lives of drugs; ambulance paramedic cover and the proximity of the nearest hospital. Here we suggest medicines that a GP might want to have available for use in an emergency or for the acute treatment of children and adolescents, updating our previous advice(2) and where appropriate we have included the underlying guideline recommendations for their use...
June 2015: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/26061586/temporal-trends-in-cardiovascular-demand-in-ems-weekday-versus-weekend-differences
#20
Kate Cantwell, Amee Morgans, Karen Smith, Michael Livingston, Paul Dietze
Diagnosed cardiovascular disease has well-reported temporal patterns, with demand distribution peaks in the late morning and greater case numbers on Mondays and in winter. We aimed to report temporal patterns of presumptive cardiovascular disease cases as determined after emergency medical services (EMS) assessment and to characterize the demand distribution by day of the week. We conducted a secondary analysis of all Ambulance Victoria cases in metropolitan Melbourne (Victoria, Australia) between January 2008 and December 2011...
2015: Chronobiology International
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